The Washington Metropolitan WINS (WMW) Consortium has enrolled and retained a representative cohort of HIV infected and HIV uninfected women since 1993 with the purpose of investigating the consequences of HIV infection and its treatment. Although significant progress has been made in both our understanding and treatment of HIV, curative therapy is still not available and the chronically administered complex therapies used to treat HIV are not always successful. Treatment with highly active antiretrovirals (HAART) appears to be associated with a wide range of adverse effects and the impact of other co-pathogens such as HPV and HCV has yet to be fully elucidated. Additionally, the early cohort of infected women is aging, and the effects of age and changes in sex steroids both on the long term outcomes of HIV, on neurocognition and the effects of HAART treatment needs investigation. The WMW has joined with centers around the country and with sites across the metropolitan Washington region to develop a scientific plan to address these issues. A successful and flexible infrastructure has been established to allow us to accomplish these scientific aims and to assure ongoing retention of this important cohort. The WMW has successfully participated in all elements of the WIHS protocol, and has actively supported the infrastructure of the national WIHS. WMW investigators have participated in all of the major WIHS scientific initiatives. Additionally, the WMW has established both a local specimen repository and contributes to the national specimen repository. As the study has matured, an increasing number of collaborations have been established with local investigators to allow for broader access to the rich repository of WIHS specimens. Further, the WMW has expanded its local epidemiologic expertise to allow for on site data analyses. This application will describe both our accomplishments to date and the structure that we have established to 1) advance the scientific agenda as outlined in Part A, 2) to continue to expand our local collaboration in order to better define the status of women with HIV, and 3) to bring to fruition the promises of a sustainable treatment of this devastating disease. [unreadable] [unreadable] [unreadable]